After the removal of the colon (large intestine) and rectum, the conventional Brooke ileostomy is the traditional surgical ostomy technique used to re-enable the elimination of waste from the body. Basically, the ileostomy specialist connects the remaining small intestine to a newly created opening in your abdominal wall, called a stoma. Once this is done, body waste goes through the shortened intestine and is eliminated continually through the stoma into a collection bag, or external appliance. In this way, waste can safely exit the body.
Unfortunately, there are many unwelcome effects that come with this solution, including wearing a collection bag, which could leak, constantly throughout the day and night. This can cause patients to avoid leaving the house or make it inconvenient to do so. Patients also face anxiety over the possibility of a leak and odor while in public, along with potential embarrassment. In addition, alterations must be made to the eating habits (and clothing choices) to accommodate and hide the bag. Despite careful chewing and diet changes, food may still become stuck and block the elimination of waste.
Over the years, there have been refinements to the traditional ostomy solutions. New surgical continence options, with less stress-inducing characteristics, have emerged for patients facing ileostomy due to colon cancer, ulcerative colitis and other intestinal disease. Not every treatment works for every patient, but if you’d like to avoid the drawbacks of the conventional Brooke ileostomy, these two options may be open to you:
The Ileoanal J-Pouch is a popular option to provide for waste elimination in a more convenient manner. With this option, you would be free of the external bag that is needed after a traditional ostomy surgery. That’s because, in this surgical technique, your ileostomy specialist connects your still-healthy small intestine to the anus, eliminating the need for an external appliance/bag. You would gain some control over the timing of your bowel movements, with the option of delaying a trip to the bathroom for up to 60 minutes. There is still some chance of leakage and anal skin irritation, however.
The Barnett Continent Intestinal Reservoir (BCIR) also creates an internal reservoir, in a slightly different configuration from the J-pouch. The internal reservoir is then attached to a valve-controlled stoma created in the lower abdominal area, below the “bikini line.” With the BCIR, you empty your internal “bag” (the reservoir created from a section at the end of your remaining small intestine), several times each day, using a catheter inserted through your abdominal stoma. Most patients find this method superior because the valve prevents leaks (of course you’re not relying on your sphincter, as you must with the J-pouch) and avoids gassy odors too. You can go to the bathroom anytime it is convenient for you, at least three times daily. As another bonus, the small stoma, where the catheter is inserted, is flat to your abdomen so that it is easily hidden under your clothing.
To learn about your personal options to the standard Brooke ileostomy, consult with an expert ileostomy surgeon right away.